The goal of the proposed research is to determine optimum care for children with all types of cancer. The research mechanism involves participation by pediatric investigators in a consortium of North Carolina and South Carolina institutions in collaborative multidisciplinary clinical cancer research protocols generated through the Pediatric Oncology Group. The proposed research grant will allow for the continued participation of Duke University Medical Center, Bowman Gray School of Medicine, Charlotte Memorial Hospital, East Carolina University Medical School and Medical University of South Carolina in Pediatric Oncology Group activities. These activities involve studies of the natural history, immunology, and multimodal therapy of all childhood malignancies. Cooperative studies among physicians from a group of medical centers allows for rapid accrual of a statistically significant number of children with cancer in order to quickly define those avenues of therapy which provide prolonged disease-free survival. Through participation in cooperative studies, the entire medical community engaged in the care of children with cancer has a focal point to provide not only improved patient care, but also improved multidisciplinary teaching and research. Our objectives for the coming years are: 1) to develop new protocols for the immunologic stratification and chemotherapeutic management of patients with malignant lymphoproliferative and myeloproliferative disorders, 2) to continue our program in brain tumor research, with particular attention to pharmacokinetic and therapeutic studies with AZQ, 3) to expand our multidisciplinary research efforts in other pediatric malignancies, and 4) to expand our outreach programs for patient care and education through our regional Consortium.